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Generic substitution does not seem to affect adherence negatively in elderly polypharmacy patients
Charlotte Olesen1, Philipp Harbig, Ishay Barat
1Department of Geriatrics, Aarhus University Hospital, DK-8000, Aarhus C, Denmark.
Pharmacoepidemiology and Drug Safety
|September 17, 2013
Summary
Generic substitution in elderly patients with polypharmacy did not negatively impact medication adherence. This suggests that generic substitutions are safe for older adults taking multiple medications.
Area of Science:
- Gerontology
- Pharmacology
- Public Health
Background:
- Polypharmacy is common in elderly patients, increasing the risk of medication non-adherence.
- Generic substitution is a strategy to reduce medication costs, but its impact on adherence in this population is unclear.
Purpose of the Study:
- To investigate the association between generic drug substitutions and medication adherence in elderly patients with polypharmacy.
Main Methods:
- A study included 672 elderly patients (65+ years) in Denmark on at least five daily prescription drugs.
- Medication adherence was assessed by pill counts, with <80% mean adherence defined as non-adherent.
- Generic substitutions were tracked via the National Health Insurance prescription database over one year.
Main Results:
- 83.6% of patients experienced at least one generic substitution.
- Patients who experienced substitutions had a lower rate of non-adherence (8%) compared to those without substitutions (16%).
- The odds of non-adherence were lower for patients experiencing generic substitutions (OR 0.46).
Conclusions:
- Generic substitution does not appear to negatively affect medication adherence in elderly patients with polypharmacy.
- There is no clear reason to avoid generic substitutions in this patient group.
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